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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Variation in response to a home intervention to support daily function by age, race, sex, and education.
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Variation in response to a home intervention to support daily function by age, race, sex, and education.

机译：支持家庭干预以支持年龄，种族，性别和教育程度的日常活动的变化。

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BACKGROUND: Functional difficulty is associated with increased frailty and poor life quality, with the oldest old, women, African Americans, and less educated persons at greatest risk of disablement. This study examines whether these at-risk groups benefit differentially from an in-home intervention previously found to effectively reduce functional difficulties. METHODS: Three hundred nineteen community-living, functionally vulnerable adults 70 years old or older were randomized to usual care or an intervention involving occupational and physical therapy home instruction in problem solving, device use, energy conservation, safety, fall recovery, balance, and muscle strengthening. Outcome measures at 6 and 12 months included difficulty level in ambulation, instrumental (IADLs) and activities of daily living (ADLs), self-efficacy, and fear of falling. RESULTS: At 6 months, for ADLs, individuals > or =80 years (p =.022), women (p =.036), and less educated persons (p =.028) improved compared to their control group counterparts. For mobility, women (p =.048) and the oldest participants (p =.001) improved relative to their counterparts. For self-efficacy, women (p =.036) benefited more than men. For fear of falling, less educated persons improved more than their counterparts (p =.001). A similar pattern was found at 12 months. For IADLs, whites improved more than non-whites at 12 months. CONCLUSIONS: Treatment benefits varied by specific participant characteristics, with individuals at greatest disability risk being most responsive to the intervention. Both white and minority participants benefited similarly except in IADL functioning. Future research should control for participant characteristics, identify underlying mechanisms for variation in treatment effects, and tailor treatment to patient characteristics and desired outcomes.
机译：背景：功能障碍与体弱多病和生活质量差有关，其中年龄最大的老人，妇女，非裔美国人和受教育程度较低的人有最大的残疾风险。这项研究检查了这些高危人群是否从先前发现的可以有效减少功能障碍的家庭干预中获得不同的收益。方法：将119位70岁以上的社区生活，功能脆弱的成年人随机分配到常规护理或涉及职业和物理疗法家庭指导的干预措施中，以解决问题，使用设备，节能，安全，跌倒恢复，平衡和肌肉加强。在6和12个月时的结局指标包括移动困难程度，器械（IADL）和日常生活活动（ADL），自我效能感以及对跌倒的恐惧。结果：在6个月时，与对照组相比，ADL≥80岁的个体（p = .022），女性（p = .036）和文化程度较低的人（p = .028）有所改善。在流动性方面，女性（p = .048）和年龄最大的参与者（p = .001）相对于同伴而言有所改善。在自我效能方面，女性（p = .036）比男性受益更多。由于害怕跌倒，受教育程度较低的人比同龄人的进步更大（p = .001）。在12个月时发现了类似的模式。对于IADL，在12个月时，白人比非白人的进步更大。结论：治疗的益处因参与者的具体特征而异，具有最大残疾风险的个体对干预的反应最大。白人和少数族裔参与者都受益于IADL的类似功能。未来的研究应控制参与者的特征，确定治疗效果差异的潜在机制，并根据患者特征和预期结果调整治疗方案。

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